The digital health space refers to the integration of technology and health care services to improve the overall quality of health care delivery. It encompasses a wide range of innovative and emerging technologies such as wearables, telehealth, artificial intelligence, mobile health, and electronic health records (EHRs). The digital health space offers numerous benefits such as improved patient outcomes, increased access to health care, reduced costs, and improved communication and collaboration between patients and health care providers. For example, patients can now monitor their vital signs such as blood pressure and glucose levels from home using wearable devices and share the data with their doctors in real-time. Telehealth technology allows patients to consult with their health care providers remotely without having to travel to the hospital, making health care more accessible, particularly in remote or rural areas. Artificial intelligence can be used to analyze vast amounts of patient data to identify patterns, predict outcomes, and provide personalized treatment recommendations. Overall, the digital health space is rapidly evolving, and the integration of technology in health

Wednesday, December 30, 2015

2016 in Digital Health Space

Digital Health Space as well as Health Train Express now have a new sidebar widget (Featured Posts). The
The featured post will change from time to time Last year we planned to change to a dot com domain  using wordpress.  That did not occur, however it will happen soon.  There will be a re-direct if you you use our blogspot.com or directly if you go to  DigitalHealthSpace.com

It is that time of year when pundits review past events for the year and futurists attempt to predict the next disruptive technology.

The past year in the Digital Health Space was a mix of success and  failure.

Telehealth and Telemedicine is taking a foothold as providers become aware of it's power to expand accessibilty and more important CMS and many insurance companies are beginning to reimburse for these services for several reasons.

An important  consideration for providers is whether mHealth apps will increase or decrease face-to-face office visits. Most providers have little if any spare time. They have little desire to see more patients, unless they are in a fee for service model (which may disappear soon), or beginning a new practice.

Professionals are somewhat confused about whether FDA approval is required to market mobile healh apps and may be reluctant to use one not examined and approved by the FDA. This may be a major delay in adoption. FDA approval would give a boost to sales and use if announced or labellled, "FDA approved". FDA approval requires a printed insert detailing limitations, waivers, and possible untoward events using the device.  The device approval process is different than drug approval.








Digital Therapies for Healthcare | EMR and HIPAA

Digital Therapies for Healthcare | EMR and HIPAA

Tuesday, December 22, 2015

Streamlining Healthcare Processes with E-Signatures -

Are you still signing medical documents, letters, and authorizations by hand?




You aren't quite a luddite.

The use of electronic or digital signatures for health documentation is increasing.  Health care is one of the last industries to adopt this labor saving functionality of digital documentation.

Most people equate the terms 'digital signature and electronic signature. However they are not the same.



  

Roughed Up by an Orca? There’s a Code for That - NYTimes.com



The next time you see your M.D you may notice a change in his demeanor. You see, on October 1st 2015 HHS'deadline for using the new ICD code passed.

As he gazes wistfully (remembering his love of the progress note and pen) at his EHR screen (instead of you) he will use another 10 seconds finding the correct code. No matter the computer does most of the work,,the physician now has to peruse over 60,000 codes instead of 14,000, select the correct one and link it to the CPT (current procedural) in order to be paid.

I feel much safer now that SeaWorld is shutting down it's live show.  However for those of  you who swim in Puget Sound or off the left coast, beware, there may be a code for that.

Much of the ICD 10 codes are used by medical departments of the department of  defense. I know, I used it about five years ago as a private contractor ophthalmologist. I was in the process of learning how to use ALTA, then the lynch pin EHR for Army Medicine.

My findings agree with all physician's opinions about electronic medical records. I had the advantage  of having used EHR before, and there was also a 2 day course in a computer training lab. That helped somewhat, however my patient load was limited to five in the morning and five in the afternoon. My normal patient schedule in private practice was about 40/day.  Even after training and use my max load wasabout 30/day, and I was hard pressed to accomplish that number.
At times I would be forced to pick a cause blindly or use one that I could find easily. I never found out if that was a real issue, or not.  The codes were probably analyzed by another program for accuracy, but I never knew.  Perhaps someone now will find out if it really matters when they receive a denal for payment from Medicare., or some other payer.

For me it no longer matters, I am finished with clinical medicine...It's up to the next generation to untangle the monster that has been created.

I could never understand why M.D.s would give advice to congress when congress never listens to experts in their field.  I did it for many years, and eventually decided I should spend more time with my family. The same pertained to CME (I started doing it all on line about 10 years ago), recertification and medical meetings.

I noted the American Board of Anesthesia will no longer require MOC or recertification. (It seems Anesthesia will be administered by a robotic anesthesia machine.  Perhaps this is the initial offense against bureaucrats.

Good luck to our new healthcare system. I hope you can fix up what we screwed up despite 30 or more years of resistance.

As the Borg say  "RESISTANCE IS FUTILE'











Roughed Up by an Orca? There’s a Code for That - NYTimes.com

Monday, November 30, 2015

Telemedicine and HIPAA Compliant Email

Welcome to 2016.

If you are a small practice (or a large one, for that matter), this post may be helpful to you.
Usually my  posts are about 'theoretical' issues surrounding HIT and Health Reform

Today will be pragmatic, with several real-time applications that you can install tomorrow, and  they come with no fees.

If you have or are going to be successful with Meaningful use, let's proceed.

Telehealth:

Telehealth promises to be a part of the solution for primary care physicians, and many others as well. Any PCP will tell you how it is impossible to meet the real needs of  his patients. The Affordable Care Act has upped the anty with an influx of previously uninsured patients,  Many of these potential patients have low incomes, at the poverty level, and do not have transportation.

The biggest issue for physicians due to a loss of income providing this service in lieu of a real office encounter. This issue has been one of reimbursement because CMS and private insurers did not remburse for virtual visits, except for a few instances.  That is all changing as CMS alters its attitude regarding televideo.

This televideo application is free of charge, it is simple, requires little technical expertise, and utilizes a desktop computer, or a smart phone.  It allow the physician the ability to call a patient,and the reverse,a patient can request a televideo connection with the physician.


Sunday, November 29, 2015

Medstrtr and Health 2.00 NYC Medstrtr Momentum 2015 #MedMo15



Monday, November 20, 2015
Hey Folks,
We are pretty excited about tomorrow.  With 24 panelists and 24 speakers including Susannah Fox, Regina Holliday, Wen Dombrowski, Peter Frishauf, Unity Skoakes, and more healthcare innovation rockstars than you can shake a stick at, it should be great.  Over 200 people are coming and it will be fantastic. 18 companies are pitching too to win over 30K in prizes too.
Get your tickets now while you still can!
The event will be livestreamed on MedStartr.tv as usual, but it will be low res due to bandwidth issues.  Follow all the action on twitter as well with Hashag #MedMo15.
Also just want to say a Big Thanks to Sponsors Microsoft, Sheppard Mullin, Cipher Health, Truveris, NJII, Mad*Pow, InGroup, and Young America Capital as well as all our collaborative organizations that helped spread the word: NYCHBL, StartupHealth, HealthDevs, Gary's Guide, New York eHealth Collaborative, NYCEDC, IoT Meetup, HITLAB, SperlingGreene, iBreakfast / Startupalooza and so many of you.  Did you know we have had 2 million impressions on twitter already?
Last but not least, we want to thank our volunteers who have pitched in to help make materials, prepare, and spread the word.  This is our biggest event ever and we could not do it without you.
See you there!
Have a great night.
Best Regards,
Alex, Anthony, and Mimi

Enhance Mobility Management with Cyber Protection Presented by AirWatch and Zimperium | Zimperium









Enhance Mobility Management with Cyber Protection Presented by AirWatch and Zimperium | Zimperium

Saturday, November 28, 2015

AMA Innovation Challenge



Medical Students and trainees often are the first to realized there is something missing in their education and training.  Your ideas are very important. New students are creative and think "out of the box" untarnished and unintimidated by the  hierarchy of medical training.


Propose solutions to transform medical education.

2.

Enter your ideas into the AMA Medical Education Innovation Challenge by Dec. 11, 2015!

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3.

Winning teams that complete the prize conditions will receive $5K for first place, $3K for second and $1K for third. First place winners will be invited to present at the Accelerating Change in Medical Education Consortium in Hershey, Pa., in March 2016.


Submit your ideas by December 11,2015 AMA Innovation Challenge

Wednesday, November 25, 2015

Healthcare providers wait for rude-awakening after ICD-10 | Healthcare Finance News

It's far too early to declare with certainty the impact of the ICD-10 transition on healthcare revenue cycles and productivity.
Initial data shows the apocalyptic warnings about ICD-10 immediately leading to claims rejection chaos were misplaced. The Centers for Medicare and Medicaid Services late last month said invalid ICD-10 codes comprised only 0.09% of error-based denials from October 1 (when ICD-10 went into effect) through October 27.
While CMS said it was "pleased to report that claims are processing normally," it's worth keeping in mind that the government agency has taken several temporary steps to smooth the transition to ICD-10 which may be masking problems that could manifest themselves down the road, including a claims denial amnesty for 12 months and advance payments to physicians in the event of processing problems related to ICD-10.
Private payers also have been going easy regarding coding requirements in the early days of ICD-10, Avery Hurt writes in Physicians Practice. And that, she believes, may be giving providers a "false sense of security" about their ICD-10 processes.




Healthcare providers wait for rude-awakening after ICD-10 | Healthcare Finance News

HCI’s Innovator Awards Program Is Open: Time to Trumpet Your Innovations | Healthcare Informatics Magazine | Health IT | Information Technology

Your patient care organization’s innovations deserve recognition. It’s time to submit your entries to the Healthcare Informatics Innovator Awards Program!
For the eighth year in a row, we at Healthcare Informatics have chosen to once again open our website to submissions to our Innovator Awards Program. As always, it is a great privilege and pleasure for us to sponsor this program. And as many readers know, the concept of team-base recognition, which began with the 2009 edition of the program, has now encompassed six full sets of multiple winning teams that our publication has recognized for their achievements across a very broad range of areas.
In 2015, we honored four teams of pioneers, at Yakima Valley Farm Workers Clinic (Toppenish, Washington); Texas Children’s Hospital (Houston); the Children’s Health Alliance (Portland, Oregon); and the Bon Secours Medical Group (Richmond, Virginia). Each of these teams has done something extraordinary in innovating in healthcare, whether it is designing highly effective population health management programs for Medicaid managed care populations, applying population health strategies to pediatric populations, optimizing specialized surgery care processes for children, or engaging in intensive care management techniques to engage a medical group’s patients.
  • Caring for about 130,000 area residents annually, leaders at the Yakima Valley Farm Workers Clinic (YVFWC) led by CEO Carlos Olivares, have invested heavily to leverage IT and analytics to provide YVFWC physicians with real-time, data-driven dashboards to help the doctors successfully execute population health management in a Medicaid/disadvantaged population care delivery and payment environment.
  • At Texas Children’s Hospital, clinician and IT leaders have achieved pioneering breakthroughs in standardizing and optimizing care delivery in the critically important area of appendicitis care and appendectomy delivery. They have been optimizing processes around pediatric appendectomy, seeking to standardize clinical practice and improve patient outcomes in that crucial area.
  • Children’s Health Alliance, a not-for-profit association of 100-plus independent primary care pediatricians in the Portland, Oregon metropolitan area, is supporting an initiative that is providing pediatric practices with population health tools; the alliance’s leaders have developed a population health risk assessment methodology that risk-stratifies children with chronic health conditions, informed by an assessment of medical complexity, patient functioning, and family factors.
  • The leaders of Bon Secours Medical Group have created a patient-centered medical home environment in which advanced information systems are gathering data from different sets of clinical and payer data to provide preventive care for high-risk patients. Technology alone though is not enough to create change. BMSG has invested in employing dozens of nurse navigators, who work at large and at individual practices and help to appropriately navigate the care for specific high-risk patients.
Meanwhile, with innovation spreading like wildfire across the U.S. healthcare delivery system, there’s no question that the number of examples like all these that are out there just waiting to be recognized is multiplying rapidly. At a time when efforts to improve care quality and patient safety, restrain costs, reduce avoidable readmissions, and apply the concepts of accountable care, bundled payments, value-based purchasing, population health, and the patient-centered medical home, as well as efforts to optimize revenue cycle management and materials purchasing, are all advancing nationwide, the opportunity to publicize team-based achievements is greater than ever.
So this is your official note of encouragement. Please consider submitting an entry describing the achievement or set of achievements that a team at your provider organization (hospital, medical group, integrated health system, health information exchange, public or community health entity, or health plan) has been able to demonstrate and document. (Please be aware that we will not accept any submissions from representatives of vendor firms; the submissions must come directly from patient care/healthcare organizations.)
The winning teams will be featured in the January/February cover story package in Healthcare Informatics, and will be honored at our Innovator Awards reception, to be held on the evening of Tuesday, March 1 in Las Vegas, during the annual HIMSS Conference. More details about the reception will be available soon on this website.
At Healthcare Informatics, we are honored to be able to showcase these kinds of case studies; the achievements that they articulate embody the core of what we hope to encourage in U.S. healthcare today. At a time of unprecedented change in healthcare, there has never been a better moment for the showcasing of such innovations. Please consider submitting an entry to our program, and good





HCI’s Innovator Awards Program Is Open: Time to Trumpet Your Innovations | Healthcare Informatics Magazine | Health IT | Information Technology

Tuesday, November 24, 2015

The Dark Side of HIT

Several Surveys on Efficacy of EHRs reveal troubling and lingering concerns about the effects on health care delivery efficiency and cost.

The Dark Side Of Electronic Health Records: Medical Malpractice Liability (pdf)
The Dark Side of the EMR &How to Live With It

The Doctor Weighs In


Health Insurance Company Member Engagement Index: The EveryMove 100 – HealthBlawg


"'TOP DOCTORS in America" or TOP DOCTORS wherever you may be, Airport,Hotels, or Tourist destinations We have all seen the shiny magazine covers announcing their selection of the best. 

Now we find a new index:

Health Insurance Company Member Engagement Index: The EveryMove 100

At last physicians can see where the 'top health insurers are as ranked by  EveryMove 100

At the outset, health plans are ranked by these five categories of consumer engagement and interaction:
  1. Social media presence and performance. Having accounts is important. Having accounts engaged in active dialogue with consumers is more important.
  2. Mobile strategy. Is there a mobile website? Are there user-friendly apps available on multiple platforms?
  3. Website statistics. How much traffic is any website getting relative to other health plans? Is the content fresh or static?
  4. Customer support.  How easy is it to find contact info? How are plans using technology to make contacting them easier?
  5. Customer satisfaction. EveryMove surveyed its own user base (100,000 nationwide) to get data on health plans.
The title Best Doctors is used cautiously as this does not pertain to clinical excellence but rather by a narrowly defined consumer rating based on social media, contact information, website statistics. 


I like the idea that consumer engagement measures are available to individuals at the time they need to make these choices. I like the use of social media presence and engagement as a key series of metrics as well. There are a million tools out there for use in choosing a health plan. I look forward to the maturing of this tool so that it can be a more useful tool for individuals facing a difficult choice.

At least as important, however, are decision tools that allow individuals to model their likely costs, so that each person can choose the best plan for his or her own specific circumstances.

And most important are the strength of their education, training and performance in the clinical space.
The metrics will be revisited on a quarterly basis by the team and advisory board (which at present includes Matthew Holt,Aman Bhandari and Garrison Bliss).


Health Insurance Company Member Engagement Index: The EveryMove 100 – HealthBlawg

When is HIT spending enough to outdistance increased Revenues ?

Report: Health Care IT Payer Outsourcing Market To Increase by 40%

In the never ending race to become more efficient, reduce labor cost and become more competitive, have we reached the point of negative gain ?

, iHealthBeat, Tuesday, November 24, 2015
The market for health care IT payer outsourcing is projected to increase by 40% over the next two years, according to a new Black Book report, FierceHealthPayer reports (Moody, FierceHealthPayer, 11/23).

Report Details, Findings  

For the report, researchers surveyed 829 health plan IT outsourcing users from the second quarter of 2015 to Q4 2015 (Black Book release, 11/20).
The researchers attributed the projected growth in outsourcing to:
  • Software tools that have accelerated expenses faster than initially expected; and
  • Revenue increases (FierceHealthPayer, 11/23).
The report found health insurers in 2016 plan to increase their spending on outsourcing by at least 20% for certain service models and functions, such as:
  • Application support;
  • Desktop support; and
  • Help desk support.
In addition, about 80% of larger health plans could start outsourcing desktop support and help desk support with the next year, according to the report.
However, the researchers found that less than 10% of health plan IT executives have considered full or end-to-end outsourcing in part because of data security concerns (Black Book release, 11/20). Black Book noted that, as of January, about three-quarters of health plans surveyed were cautious about major outsourcing initiatives (FierceHealthPayer, 11/23).
The report authors wrote, "With concerns over hostile offshore locations and escalating health data security and privacy issues, fewer payers are entertaining having a third party overseas corporation between them and their IT nervous systems in 2016" (Black Book release, 11/20).
Meanwhile, the report also found that demand for big data and analytics to support population health initiatives will increase because of health plans' investment in:
  • Consumer-facing mobile applications;
  • Remote health monitoring; and
  • Virtual care (FierceHealthPayer, 11/23).
Source: iHealthBeat, Tuesday, November 24, 2015

Thursday, November 19, 2015

End of Year Predictions

During the last decade we have seen enormous changes in clinical medicine, and it's business workings. Some of  it has been very good, and much of it has been disruptive. Much of life is letting go. In order to move forward each year, something  gets left behind.

It began with bronze, then iron, then nano-technology. Horse power was replaced by steam engines, then combustion engines, now being replaced by electric engines.

In health care much the same is occurring. Few would recognize or remember the technology used to  perform lab tests, diagnostic testing and treatments from 20 years ago. We are now passing through the first  stages of information technology and the digital language that makes today's medical care possible.  As we traverse each iteration a new one appears and we cast off the old reluctantly. Learning new techniques are  time consuming until mastered.

My own story as an ophthalmologist beginning in 1978 mirrors what is now occurring  in health information technology.

In 1977 it was common for a cataract removal to take over one hour or more. The recovery period required sandbags and a three day hospital stay. Numerous advances in material design, and operative technique created a nexus.  The addition of micro surgery, intraocular lenses and a revolutionary method of dissolving the crystalline lens made for a major change, including better outcomes fewer complications, creating the ability to have a fifteen minute surgery and an outpatient encounter of less than two hours door to door. In 1977 in order to see clearly it required special thick lenses or a custom contact lens. Today in 2015 we have intraocular lenses which are placed in the eye at the time of cataract removal.  Vision is  restored within several hours following surgery, and not infrequently there is no eye patch !

Mine was not a  unique experience. Other specialists, in orthopedic surgery, neurosurgery, abdominal surgery, have gained from what I like to call "scopology",  endoscopes, laparoscopes, small incision back surgery, even small incision heart surgery.

What is coming next will effect not only medicine, it will effect almost every industry, from entertainment to retail sales, travel, and home.

By chance I happened to receive an email, one of those that takes you to a lengthy video that you  cannot stop, but are drawn to remain by it[s content and promise of some special  deal with a money-back guarantee if dissatisfied.  This was no different.  However, buried within the presentation were the facts that a new device  would soon be entering the market.  The smart watch and other wearable are a brief pit stop on the way to a device akin to  Mr Clean's all in one magic  sponge.  It is predicted that over 500 million will be purchased in the initial two years of production. What it is will revolutionize our lives in medicine, at the store, and in the home or wherever you may be. It is a device that is worn and works passively with little, if no input from the user.

Like most mobile devices, at first, they will be very expensive. However in a relatively short period of time they will become ubiquitous and available in inexpensive material such as rubberized neoprene, or plastic material. They will be available as expensive jewelry, embedded with gems in a variety of metals.  The electronics will be in a removable cartridge to be transferred from your daytime wear to evening apparel.

Daytime Wear


 Evening Wear
 Special Occasions


Apple, LG, Nokia and Samsung are all waiting to capitalize on this development.  The journey from tablet PC to  handheld phones, smart watches are all development tools to design and produce the Smart Band. The inner workings of this band contain some proprietary components that will make some companies and people very rich. It includes GPS, RFID, connectivity, and considerable computing power. The device will have a  relatively short half-life....designed to be replaced with new technology every year or so, just as Apple and Android smart phone manufacturers release new iterations each year with new functionality.  The driving force is to  be able to do more with less.  This innovation cycle is what drives our economy.  It has for a very long time in consumer devices, cars, appliances. We see now that fewer and fewer gadgets can be repaired, it is now a throw away market place. Labor has become more expensive than parts.

Think of all the occurrences during  your day from arising in the  morning, eating breakfast, driving to the office or hospital, waiting for your first patient, travelling to the hospital, making rounds and more. Messaging  has become commonplace but requires active participation.  Imagine a wearable that would calculate  your location and signal whoever is waiting for you where you are and how long it will be until your arrive. No more calls from the O.R. the floor, your partners, or anyone expecting to meet with you that day. All of this without the wearer lifting a finger. If you planned to meet someone for lunch the device will notify your favorite eatery and have  your selection hot and waiting for you. After your meal it will automatically pay your bill.

The only choice will be which wrist do you want to wear it on? Oh yes...color and do you want it engraved?

California Researchers Eye Robots To Help People Age at Home - iHealthBeat

 University of California-San Diego researchers are working to develop robots that can listen, speak and react to human needs.

Earlier this month, the university launched its Contextual Robotics Institute, a multi-disciplinary effort to develop robotic technology with artificial intelligence that can be used to help the country's growing elderly population "age in place."  
Rajesh Gupta -- professor and chair of the computer science and engineering department at UC-San Diego -- said the new institute's work is unique in that it draws heavily on cognitive sciences with the goal of developing robots that can read emotions and respond to people more like humans.
The field of robotics is growing at a rapid pace. Universities and technology companies are working on self-driving cars, robots that can clean hotel rooms and a wide range of other robotic applications.
Until now, Gupta said, robotics have focused primarily on mechanical functions, such as driving, flying, or manufacturing.
"So, all robotics in the past have been with machines that have stiff joints, things which are mechanically strong," he said.
"When it comes to interaction with humans, most robotic machines are too stiff or too autistic. They don't really make a distinction between what you're thinking or feeling," Gupta said.
UCSD's new  institute will bring together experts in the fields of engineering, computer and social sciences to develop machines that Gupta said will be able to recognize their environment, understand the context of a situation and synthesize the information to take the appropriate action.


To be useful in a home setting, he said, "The robot has to be able to sense things, not necessarily be told to do everything."
As most seniors prefer to 'age in place' robotics will play an increasing role for assisted or independent living. The possibilities are enormous, however there are limits.



VA Proposes Changes To Ease Electronic Health Data Exchange

VA Proposes Changes To Ease Electronic Health Data Exchange  



Meanwhile, VA officials on Wednesday also proposed measures to improve the VA Choice Card program, which aims to help veterans access care more quickly, Modern Healthcare reports (Muchmore, Modern Healthcare, 11/18).
During a House Committee on Veterans' Affairs hearing, VA Deputy Secretary Sloan Gibson proposed changes to improve the Choice program by:
  • Clarifying the program's eligibility criteria;
  • Creating a "high-performing network" of private providers who work with VA;
  • Enabling VA to electronically share medical records with outside providers; and
  • Streamlining payment protocols (AHA News, 11/18).
Gibson said VA would spend $421 million to implement the changes during the upcoming fiscal year. According to VA estimates, the initiatives would cost $400 million to $600 million annually in subsequent years. According to the Washington Times, the changes could cost more if additional patients wish to participate in the program (Shastry, Washington Times, 11/18).

Baby Steps: Will Boomers Buy Into Mobile Health? -

Mobile Health Apps  Part II  Who will be using them ?



 Mobile health technologies include apps, gadgets, and tech-enabled services such as sensor-based activity trackers, wearable patches, and personal health devices. By improving self-care, all of these offer potential benefits to providers, payers, and consumers.

Investors and inventors, spurred by the Affordable Care Act (ACA), are eager to serve the growing interest in these technologies, and a prime target market is the baby boomer generation because of its massive size and the looming health costs it represents.
But the boomer response has been disappointing so far. This issue brief by health tech industry analyst Laurie Orlov looks at the fit between existing products and senior consumers' needs. Drawing on interviews with a wide variety of tech industry experts, health plans, and consumer groups, Orlov points out specific mismatches between what inventors want to accomplish and what boomers are likely to buy and use.
She also forecasts ways that the mobile health tech market will change and how those changes could benefit the boomer generation and improve their self-care.
The complete issue brief is available as a Document Download.




Baby Steps: Will Boomers Buy Into Mobile Health? - CHCF.org

Wednesday, November 18, 2015

5 Steps to an Enterprise Mobility Management Program | Mobiquity

One of the key barriers to acceptance of mobile health applications is the lack of 'corporate governance'. For a solo practice, this is not an issue. For groups, small, large, multi specialty or single specialty harnessing the power of mHealth requires a  unifying approach.  

Rather than approaching this as individual physicians a group should apply 'corporate governance'. This is used already by groups i n terms of purchasing, sharing diagnostic and therapeutic devices.  It allows for cost effective and efficient use of resources, spreading the capital investment across the medical enterprise.

Medical entities are still playing catch up in the name of improving workplace productivity. The speed with which we now communicate and manage every aspect of our personal lives is a healthy reflection on the importance of mobile. With nearly two-thirds of Americans owning smart phones, businesses realize they are losing out on efficiencies that these devices can bring, if leveraged appropriately, to a corporate environment. It's generally accepted that if enterprises can manage security and avoid the potential loss of personal and clinical information, then embracing mobility is a move they need to seriously consider.

The range of device management policies from BYOD (Bring Your Own Device) to lesser known policy COPE (Corporately Owned Privately Enabled) can help to guide you in deciding what might play well in your organization.

1. Support multiple device platforms.




From iOS and Android to Windows and Blackberry, companies with a BYOD policy will need to ensure each type of device is covered.


 This should also include coverage for laptops and tablets which are continuously being made smaller and more convenient to carry around. Keep in mind that it’s very important to not only publicize which type of device you’re allowing on your network, but also what version of the operating system. For example, it’s common for enterprises to allow iOS version 9.1, but reject any devices running iOS version 9.2 beta, due to potential security concerns, even though Apple has publicly released it. 
Choose mHealth applications that are available on both iOS, Android. and Windows phone. Remember Blackberry offers fewer options for mHealth.  Custom design applications will enhance branding your clinic.  There are many developers available for users to design their standalone mHealth app to integrate uniformly for messaging, patient education and access to your EHR portal.

The release of Windows 10 and an increase in users makes it possible for mHealth apps to be developed profitability for the Windows platform. The advantage of Windows phone is that the graphic user interface is identical across the desktop tablet and phone. 

Keep in the back of your plan the introduction of the smart watch.

2. Secure your corporate apps.

As stated above, it may not be necessary to lock down devices with iron clad MDM policies. Instead, see what level of MAM can be applied to your corporate applications themselves--that may be enough, and will create a more friendly work environment.

3. Build a secure app catalog.

Your users will feel empowered to choose from an app store of corporate-approved applications. If the security needs of your organization require more control, you can always use traditional MDM policies and restrict which types of apps are allowed on corporate-approved devices.
4. Implement inventory and search capabilities.
It is difficult to continuously know where all devices are, who is using them, and to what purpose. Employing an MDM tool capable of reporting on these metrics will go a long way towards ensuring that devices are allocated where they need to be.

5. Simplify the enrollment process.
Make it easy for end users to enroll their devices by visiting a simple URL and apply a default policy. This will reduce the overhead for the IT department as well as move employees toward a greater level of compliance. Corporate policies need to explicitly state to the employee base when and how assets are being tracked to ensure there are no hidden privacy violations.  It’s always best to aim for complete disclosure and clarity of what is and what is not tracked.
Businesses approaching the issue of mobile device security with these principles in mind will be able to effectively address their mobile security concerns. While IT cannot predict future enterprise needs and potential new security scenarios, laying a foundation of a friendly and secure Enterprise Mobility Management program, backed by secure MDM, will yield greater confidence from workforce, shareholders and management alike.

Monday, November 16, 2015

Believe it or not, young physicians love their electronic health records







In a not so shocking display of affection, a millenial demonstrates his affection for his constant companion, the electronic health record. However, like any relationship the mood can change abruptly.

We often develop a love-hate relationship with our 'significant other', Why should it be different with an inanimate object?

As more hospitals move to electronic health records (EHRs), many physicians have started writing about their growing discontent with the new systems. Authors have declared that EHRs are poorly designed, inefficient, lead to over-billing, and aredownright dangerous. When my supervising physicians gripe about this, I mainly nod along to avoid conflict. But I have a confession to make: Most physicians currently in training love electronic health records.
I don’t disagree with the arguments my more experienced colleagues make about the limitations of EHRs. I know many of their criticisms are based on experiences that most younger physicians haven’t had, especially with regards to how EHRs affect running a practice. But it doesn’t matter. Because young physicians have embraced EHRs, it guarantees they will flourish moving forward. Why do resident physicians like EHRs? Some argue it is because it is the only thing we know, but I disagree.  Despite their flaws, EHRs increasingly allow us to cut back on busywork and focus more on being a better, safer doctor.
There are many great examples of how EHRs have started doing this. They allow us to make templates for notes for the same types of diagnoses, which not only saves time, but also prompts us to garner the same key information for each patient. Likewise, they allow us to create order sets or checklists to ensure that we don’t forget about prophylaxis against DVT’s or a patient allergies when placing orders (similar checklists have been shown to improve patient safety). But for those of us who still remember life pre-EHR, the best example of how EHRs have improved resident physicians’ lives can be understood by their effect on the daily process of taking care of patients in the hospital.
Everyone agrees that the current systems need improvement, and I understand that with any new technology, new unforeseen consequences can arise.
Still, EHRs are ingrained in how up-coming physicians practice, and as many authors have predicted, we will be their champions. In fact, I have a number of resident physician colleagues who now consider a hospital system’s EHR to determine where to apply for jobs or seek fellowships after residency. In short, while AMA survey data may show decreasing satisfaction with EHRs amongst physicians, for my generation, it may be that we’re expecting more from EHRs, not that we want to go back.
Manan Shah is a physician who blogs at MananMD.com. He can be reached on twitter@mananshahmd.



















Believe it or not, most young physicians love their electronic health records

Sunday, November 15, 2015

Computer Science, Electrical Enginers and Health Disruption

Not many physicians have a background in computer science, or electrical engineering.  However, we all are experienced with Health and Disruptive Technology.

Numerous schools of engineering are now challenging their students with electives in  health information technology.  Among these are the School of Engineering at U.C. Berkeley.


The Berkeley ENGINEER (Fall 2015) features an editorial by S.Shankar Sastry, Dean and Roy W. Carlson Professor of Engineering entitled "Disrupting Health Care by Design" Dean Sastry reveals that it is designed to disrupt, and not engineered to provide a smooth transition to health information technology.

Health information technology is so different from business, banking, basic science, aerospace engineering and other disciplines, requiring software to translate clinician input to usable computer language, the basic underlying code that is used may be very inefficient.

It reveals the lack of collaboration between engineers and clinicians.  Clinicians need to be involved in the education of computer science engineers. The first editions of HIT, EHRs and the like sadly reveal the failure of design parameters. The growth of HIT and computer science were and are still not synchronized.

It will require re-thinking the design process and a plan to improve collaboration of engineers and physicians on the bench of computer engineering laboratories.  The construction of software platforms for health care comes late in the game. The lack of collaboration has resulted in inefficiency and increased cost.

Clinicians and Engineers should be collaborating early in the education of both disciplines. These needs may require electives or perhaps dual majors in either discipline.



Saturday, November 14, 2015

Small Rural Hospital Improvement Grant Program (SHIP) Department of Health and Human Services Health Resources and Services Administration

Small Rural Hospital Improvement Grant Program (SHIP)
Department of Health and Human Services
Health Resources and Services Administration




Health Resources and Services Administration

This announcement solicits applications for the Small Rural Hospital Improvement Grant Program (SHIP).  The purpose of the SHIP is to help small rural hospitals of 49 beds or less, do any or all of the following: 1) enable the purchase of equipment and/or training to help hospitals attain value-based purchasing provision in the Patient Protection and Affordable Care Act (ACA); 2) aid small rural hospitals in joining or becoming accountable care organizations, or create shared savings programs per the ACA; and 3) enable small rural hospitals to purchase health information technology, equipment, and/or training to comply with meaningful use, ICD-10 standards, and payment bundling.



Link to Additional Information:
Contact Information:If you have difficulty accessing the full announcement electronically, please contact:

Department of Health and Human Services, Health Resources and Services Administration bware@hrsa.gov 
Contact Bridget Ware at (301)443-3822 or email bware@hrsa.gov


View Opportunity | GRANTS.GOV



Digital Health Space provides this information without charge as a public service announcement. No guarrantees as to the availability or funding status of the grant.

Friday, November 13, 2015

In The Beginning






PwC: Healthcare reform represents a $1.5T 'gold rush'MedCity News


Changes in the way health care is delivered, paid for and analyzed through big data, as well as the slow emergence of empowered patients, are creating a “modern-day gold rush,” according to three strategic consultants at PricewaterhouseCoopers. As much as $1.5 trillion in annual spending and $150 billion in profits are “up for grabs” during this health care reform, they said.
The winners will be those who can bring critical thinking and radical redesign of a broken industry, rather than people looking to make a quick buck by exploiting current flaws, said the consultants, Carl Dumont, Sundar Subramanian and Christoph Dankert, of PwC’sStrategy& consulting team.
“Confronted with the changes, incumbents will have to reconsider their competitive positions. And upstarts and those in adjacent industries will be compelled to assess where — and even whether — they can fit in,”
“Confronted with the changes, incumbents will have to reconsider their competitive positions. And upstarts and those in adjacent industries will be compelled to assess where — and even whether — they can fit in,” they wrote in PwC publication Strategy+Business. “Players that thrive in this boom town will do so by decreasing medical spending in a consumer-oriented manner, and by capitalizing on newly informed consumer choices by improving outcomes.”
They expand on the “gold rush” analogy by dividing health care companies into gold miners and bartenders. Gold miners are “vertically integrated” organizations that “take ownership of health care,” the authors said.
They profit by mining value out of a resource — for example, by managing the health of a specific population, such as patients with diabetes, heart disease, or cancer. The gold miner strategy is closely aligned with population health management, which takes a deep understanding of chronic care to promote a 360-degree, long-term management approach. Dealing primarily with people who are sick, these large institutions — insurers, hospitals, and physicians groups — profit by improving outcomes and sharing in the savings.
Theranos is a leading example about mining resources 

Walgreen is partnering with others such as MDLIVE to deliver telemedicine, as well as adopting EPIC EHR for their walk-in clinics






PwC: Healthcare reform represents a $1.5T 'gold rush'MedCity News